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It is bordered to the east by the Central African Republic , to the south by Congo , to the north by the Adamawa Region , and to the west by the Centre and South Regions.
Historically, the peoples of the East have been settled in Cameroonian territory for longer than any other of the country's many ethnic groups, the first inhabitants being the Baka or Babinga pygmies. The East Region has very little industry , its main commerce consisting of logging , timber , and mining. Instead, the bulk of its inhabitants are subsistence farmers. The region is thus of little political import and is often ignored by Cameroonian politicians.
This coupled with the low level of development in the province have led to its being dubbed "the forgotten province". The soil of the East is predominantly ferrallitic , rich with iron and red in colour. The southern three quarters of the region consists of metamorphic rock such as gneiss , schist , mica , and migmatite. Starting at about the level of Bertoua and going north, however, granite becomes the dominate soil component.
While the region supports an abundance of plant life, it is not particularly fertile due to leaching caused by the humid environment. Eastern dirt hardens quickly in the sun, and it is often used as a building material by poorer inhabitants. Many of these rivers have carved out valleys that surround them. The rivers of the territory have only slight gradients, and floods can occur along them during the rainy season. The Lom and Nyong rivers eventually empty into the Atlantic Ocean. All other rivers in the East form part of the Congo River basin.
Almost the entire territory of the East Region lies on the South Cameroon Plateau that forms the southeastern half of the country. The elevation thus varies between and metres above sea level except for lower-lying plains of to metres in the extreme southeast centered on the Dja, Boumba, Sangha, and Ngoko Rivers. The land consists largely of monotonous, gently undulating hills known as "half-oranges" due to their resemblance to that fruit.